I. SYMPTOMS OF THE ILLNESS
Symptom: Children with bipolar disorder often
have a reversal in their sleep/wake cycle and it is extremely difficult
for them to get to sleep at night and to wake up early in the morning.
He or she seems half comatose or extremely grumpy and sleeps through
first and possibly second period, often missing important class
material and doing poorly on tests in the first two periods.
- Schedule academic classes later
in the day when the student is more alert and emotionally available
- Allow the student to take important
tests later in the day when the student may be able to focus better.
- Allow the student to begin
the school day a little later.
Symptom: The student has daily and seasonal
fluctuations in mood and energy and is therefore more attentive
to classwork at certain times and less attentive at others.
- Create formal contingency plans
when the student is unstable and is experiencing periods of withdrawal
or fatigue (a symptom of the illness and often a side effect of
student can experience great irritability, building to a rage if
recognized and dealt with in an appropriate and timely manner.
- Assign a staff/school person
who the student can go see when he or she feels unable to cope.
This can be a counselor, school therapist, teacher, or any other
person (campus monitor, school nurse, etc.) with whom the student
feels safe and whom the student trusts and chooses. Give the student
a permanent pass and a private signal that only he and the teacher
understands so that he can make a private exit in front of the
rest of the class.
- Offer the student a private
place to go to calm down when feelings are overwhelming.
- Schedule regular meetings with
the school psychologist to teach the student self-calming and
anger management techniques.
- Assign an aide in the classroom
to prevent situations that may cause the student to lose control.
- Administer a Functional Behavior
Assessment to identify triggers that cause the student to lose
control. Then write a Behavior Intervention Plan to be added to
the IEP which provides appropriate interventions for problematic
behaviors. This can be as simple as identifying stressors which
cause untoward behaviors.
Symptom: The student has periods of excessive
anxiety and sadness.
- Assign a safe place and person
where the student can regroup and calm down preferably someone
with whom the student can talk easily.
- Have the student keep a journal
in which he or she can address anxiety-producing thoughts and
school experiences which can be shared with the school psychologist
and the students personal therapist.
- If the treating psychiatrist
recommends the use of a light box, provide this daily during a
study period in the resource room.
Symptom: The student is very perfectionistic
and has difficulty making transitions.
- Reduce writing by allowing the
student to use a computer so the page looks neat to him or her.
- Allow student to finish tasks
before moving on.
- Have all teachers cue the student
as to transitions and the time they will occur.
- Provide an aide who will give
support during non-supervised periods of the school day (lunch,
recess, escort to and from the bus waiting area, etc)
- Allow student to transition
ahead of the rest of the class (going to lunch room, library,
Symptom: The student has difficulty with peers.
The student may have poor social skills, be bossy, misperceive the
behaviors and intentions of others, and be socially inappropriate
- Arrange for the student to learn
social skills and group behavior by meeting with the school social
worker, school psychologist, or the guidance counselor.
- Develop a social skills class
and have the student participate in it.
- Place an aide in the classroom
who can monitor social interactions and report incidents of social
conflict. The aide can interpret and explain to the student how
things occurred which may be outside the students perception.
This aide can advocate for the child, act as a friend, make the
child feel safe, and alert the school if there are any incidents
of bullying going on.
Symptom: The student becomes overheated and
overstimulated in gym classes and begins to suffer discomfort or
to cut class.
- If the student participates,
he or she must always have access to water and rest.
- The student should have the
option of less competitive physical activity such as Yoga. Tae
Kwan Do, weight training, aerobics, etc.
- The student should be graded
based on attendance rather than participation.
- If necessary for the students
emotional well-being, have an Adaptive P.E. written into the IEP
until such time as the student is ready for mainstream physical
- If inclusion is an issue or
a desire on the students part, the student could be appointed
score keeper or equipment manager.
II. SIDE EFFECTS OF THE MEDICATIONS
Symptom: The student is experiencing excessive
thirst, a frequent need to urinate, or bouts of diarrhea as a result
of some of the medications used to treat the illness (especially
in the early stages of treatment).
- Allow the student to keep a
water bottle at his or her side or to have unlimited access to
- Allow unlimited access to the
bathroom (with a signal to each teacher as to where the student
is going--without announcing it publicly)
- Educate the staff (especially
the school nurse) about medication side effects which may include
drowsiness, diarrhea, stomach aches, and cognitive dulling and
the need to accommodate for these.
Symptom: The student is sleeping in class
because his or her body is not yet accustomed to a new medication.
- Provide a place for the student
to take a brief nap so that he or she can continue with the school
day. (Sleepiness usually subsides as the body adjusts to the medication).
Symptom: The student is experiencing cognitive
dulling and a lack of endurance as a result of the medication(s).
- Schedule frequent breaks.
- Provide extra time for work
- Decrease workload and homework.
ATTENTIONAL AND ORGANIZATIONAL DIFFICULTIES
Symptom: Student has difficulty staying on
task and paying attention for any length of time. Student is very
fidgety in the classroom.
- Seat student close to teacher
where the teacher can get students attention.
- Schedule frequent breaks.
- Offer choices such as going
to a study carrel in the library or to a quiet area outside the
- Assign a study buddy (use the
phrase study-partner for an older student). The students can focus
each other and acquire strategies for learning from each other.
Symptom: The student is disorganized and often
misplaces needed books and materials. The student often forgets
to bring home assignments and/or fails to turn in work.
- Use a travel folder.
This is a pocket portfolio that has necessary papers to complete
on the left-hand side (mark this To Do) and all completed
homework is transferred to the right-hand side (mark this Completed).
- Give student a planner book
and have teacher check that daily assignments are recorded properly.
- Email or fax parents list of
assignments and news of upcoming projects or tests.
- Have teacher or aide give the
student a prompt before leaving school: What do I need to
do tonight and what materials would I need to accomplish it. I
need: my coat, my recorder, my math book, my study sheet for French,
my planner, my lunch box, my travel folder (French sheet is there...)
The teacher or aide could photocopy lists of materials and clothing
and have student check items off as they are put in the bag. Student
must be taught to pack backpack to return to school the same way:
with a prompt such as What do I need for school today?
(A parent has to help out here.)
- Provide a second set of text
books for the home work area.
- Teach the student to number
assignments in the order in which they should be done before beginning
a homework session (thus they will focus and begin a mode of strategy).
Have the student start with an assignment that is short and easy,
but avoid saving the hardest or longest assignment for last. Have
the student estimate how much time it will take to complete each
assignment and measure the estimates against the actual time (these
students have difficulty with time management). Have them use
a stopwatch to assign chunks of time to each step of a study plan
which will help move them on to the next step.
- Teach the student to preview
questions at the end of each chapter to focus him or her on important
concepts. The student should also preview photos, captions and
headings throughout the chapter before reading and when reviewing
for a test.
- Color-code subject folders and
notebooks to match textbooks. For instance, if the math text is
orange, place an orange strip of tape on the math folder and notebook
so that student can quickly locate and assemble all materials
needed for math. If school requires the books to be covered, color
coordinate the books and folders.
- If the student uses a locker,
teach him or her to place all morning text books, notebooks and
folders on top shelf of locker, and all afternoon materials on
lower or bottom shelf. This will help organize the student and
ensure that he or she goes to class with the correct materials.
Have the student (with the help of an assistant if necessary)
clean out locker at least once a week. Schedule that cleanup on
Fridays to ensure that P.E. clothes and needed materials arrive
home for weekend use.
IV.SPECIFIC LEARNING DISABILITIES
Accommodations for Reading Disabilities or Dyslexia
Children with reading disabilities or dyslexia have
problems decoding the phonetic structure of language, which negatively
impacts comprehension. Absent previous remedial reading interventions
(such as Orton-Gillingham), the student may need some or all of
the following accommodations.
- Provide student with larger
- Arrange for student to receive
books on tape through the Recording for the Blind and Dyslexic
in Princeton, NJ. Contact them at: http://www.rfbd.org/catalog.htm
- Provide books that have information
- Have student use tape recorders
in the classroom.
- Provide readers for tests.
- Allow extra time for tests.
- Provide materials that use lots
- Provide information in bullet
- Teach the student to take notes
and to study using visual techniques instead of words.
- Provide hard copies of notes
provided to the student.
- Teach mapping techniques.
- Allow extra time for assignments.
- Do not penalize the student
for spelling errors.
- Provide computer-based reading
software such as Kurzweil 2000 or Wordsmith which scans textbooks
or other reading material into a computer and audibly reads the
scanned text back to the student. (In Wordsmith, the student has
a choice of a male or female voice or a British or American accent.)
Look at http://www.dyslexic.com
to learn more about these products.
for Writing Disabilities or Dysgraphia
Children with writing disabilities or dysgraphia generally
have problems with handwriting (the actual formation of the letters)
as well as deficits in written expression. When writing, these children
may omit words or reverse them, and syntax and grammar are often
incorrect. These students may also have difficulty deciding on a
topic for an essay or organizing it so that the ideas flow in a
logical manner. These problems may not show up in expressive language
assessments and may be exhibited only in the written language assessments.
Students with writing disabilities or dysgraphia will need some
or all of the following accommodations:
- Teach and encourage the student
to use a keyboard in class and to complete all assignments.
- Assign a scribe to write longer
or timed writing assignments.
- Allow student to tape record
classes. Do not penalize quality of note-taking or assume the
student is not taking it all in aurally.
- Provide paper copies of notes
to the student.
- Allow extra time for assignments.
- Assign a scribe for important
tests, or allow the student to give his answers orally.
- Do not penalize the student
for handwriting or spelling errors.
- Have the parents investigate
voice recognition software such as Dragon Naturally Speaking
(also available on http://www.dyslexic.com).
for Math Disabilities or Discalculia
Children with math disabilities or dyscalculia generally
have problems in math computation, function and application of math
concepts. and in understanding the basic math functions. For example,
they may reverse their numbers when they are writing. Students with
math disabilities or dyscalculia may need some or all of the following
- Provide math books in larger
- Give the student graph paper
to keep numbers in their correct columns
- Provide manipulatives to help
the student understand in a concrete way the abstract nature of
- Provide a student with a calculator
for more complicated math functions and teach the student to use
- Do not penalize students
grade for the reversing of numbers.
- Allow extended time for assignments
Negative Remarks that Threaten to Derail the IEP Process >
This article was written by Janice Papolos (co-author
of The Bipolar Child, Revised Edition), Mary Jane Hatton, and Sandi
Norelli, (co-directors of the JBRF Educational Team), Christine
E. Garcia, M.Ed., and Anne Marie Smith, M.Ed.
Copyright © 2002. All Rights Reserved.
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